Stroke is the third leading cause of death in the United States and the leading cause of disability among adults. Currently, there are roughly 4 million stroke survivors with some sort of neurological impairment with $43 billion each year in health care costs and lost productivity. The main goal of this Phase II proposal is to develop, build and test a portable and non-invasive diffuse optical tomography (DOT) system for functional brain oxygenation monitoring. The objective of the innovation is to allow for continuous wave, real time measuring of cerebral hemodynamic activity associated with brain function, and to apply it to the study and clinical management of functional recovery in stroke survivors. This innovation promises the delivery of new technology for helping to improve in the diagnosis, treatment and care of stroke patients. In this program our Aims are to (1) develop DSP hardware modules with firmware; Aim (2) develop software capable of providing and visually displaying recordings in real time from 32 lasers and 32 detectors, generating 1024 single channels (i.e., with a 10 ms temporal resolution); Aim (3) conduct test verification in phantoms and in clinical studies of stroke patients. The test experiments will help to determine the extent of brain damage in stroke patients and to evaluate the benefits of exercise in the motor cortex. With continued funding, this Phase II enhances the value of other funded studies by NIH and for the general scientific community, who benefit from the advancement of non-invasive technology for other brain monitoring applications, such as epilepsy, dyslexia and head trauma. The continued funding and development will enable increased sales and commercialization for an improved portable, non-invasive brain-monitoring device. The long-term value for stroke patients is a medical device that provides continuous brain monitoring during treatment at the bedside in the hospitals and for therapy in rehabilitation centers and in-home. The long-term value for the health care community is improved quality of care at lower costs and less suffering. [unreadable] [unreadable] [unreadable]